Cigna Healthcare Providers & Facilities
Important Updates from Cigna:
Effective August 1, 2022, Kaiser Permanente (KP) members with HMO (health maintenance organization) or participating EPO (exclusive provider organization) plans began to have access to emergency and urgent care services at Cigna Healthcare negotiated rates via Cigna Healthcare’s PPO (preferred provider organization) Network* of providers when traveling outside Kaiser Permanente states (outside of California, Colorado, District of Columbia, Georgia, Hawaii, Maryland, Oregon, Virginia, and Washington) and if applicable, no payments are required from eligible** members until after the claim is priced by Cigna Healthcare and paid by Kaiser Permanente.
Similarly, effective October 1, 2022, Kaiser Permanente members with POS (Point of Service) 2-Tier plans began to have access to emergency and urgent care services at Cigna Healthcare negotiated rates via Cigna Healthcare’s PPO Network* of providers when traveling outside Kaiser Permanente states and if applicable, no payments are required from eligible** members until after the claim is priced by Cigna Healthcare and paid by Kaiser Permanente.
Effective January 1, 2023, Kaiser Permanente Insurance Company (KPIC)*** PPO and Kaiser Permanente’s 3-Tier POS members began to have access to the Cigna Healthcare PPO Network* for most covered services including, but not limited to outpatient and inpatient services, emergency and urgent care services at Cigna Healthcare negotiated rates via Cigna Healthcare’s national PPO network of physicians, hospitals, and urgent care clinics while outside of Kaiser Permanente states. Additionally, this change became effective January 1, 2024, for Oregon situs members enrolled in PPO and 3-Tier POS coverage issued by Kaiser Foundation Health Plan of Northwest.
Through this collaboration, Cigna Healthcare PPO Network providers outside of Kaiser Permanente States will be reimbursed for qualifying services they provide to eligible** Kaiser Permanente (HMO, EPO, POS 2-Tier, 3-Tier POS) or KPIC (PPO) members. However, Cigna Healthcare PPO Network providers outside of Kaiser Permanente States should only collect appliable cost share (once their eligibility and benefits are determined) from eligible Kaiser Permanente 3-Tier POS or KPIC PPO members at the time of service.
Eligible** members may present a Cigna Healthcare-branded Travel Card, or co-branded Physical or Digital Membership Card, indicating plan participation.
Note: For providers that are NOT a Cigna Healthcare PPO Network Provider Outside a KP State or if the member is ineligible (on a Medicare or Medicaid product), please follow existing processes on the regional/national pages by navigating to them in the footer below.
*The Cigna Healthcare PPO Network refers to the health care providers (doctors, hospitals, specialists) contracted as part of the Cigna PPO for Shared Administration. Cigna Healthcare is an independent company and not affiliated with Kaiser Foundation Health Plan, Inc., and its subsidiary health plans. Access to the Cigna Healthcare PPO Network is available through Cigna Healthcare’s contractual relationship with the Kaiser Permanente health plans. The Cigna Healthcare PPO Network is provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company. The Cigna Healthcare name, logo, and other marks are owned by Cigna Intellectual Property, Inc.
**Eligibility Exceptions: The Cigna Healthcare PPO Network* enhanced experience for our members is not available to:
- HMO, EPO, PPO, & POS members enrolled in coverage issued by Kaiser Foundation Health Plan of Washington and Kaiser Foundation Health Plan of Washington Options, Inc.
- Washington situs PPO and 3-Tier POS members enrolled in coverage issued by Kaiser Foundation Health Plan of Northwest.
- Medicare members
- Medicaid members (Medi-Cal in California)
***Kaiser Permanente Insurance Company (KPIC) is a subsidiary of Kaiser Foundation Health Plan, Inc. (KFHP).